Project Summary: Postpartum depression (PPD) constitutes a general health problem occurring in 10-16% of recently delivered mothers. The impact of PPD is profound with considerable emotional pain for the mother as well as disturbances in infant development and later child adjustment. Although the prevention of this disorder has garnered much attention, few preventative interventions have demonstrated efficacy, replicated findings, used validated diagnostic measures for PPD, or used heterogeneous samples of women. The ROSE Program (Reach Out, Stay Strong, Essentials for mothers of newborns), an intervention that has been found in three clinical trials to significantly reduce cases of PDD in at risk pregnant women on public assistance, targets those factors that play a significant role in the development of PPD (i.e., poor social support, role transition, and life stressors) and is administered during weeks 20 - 35 of pregnancy and within 2-weeks postpartum. The aims of the phase 1 of this SBIR proposed project is to develop a high-reach, easily implementable, low-cost, prototype of the ROSE Program and test its acceptability and feasibility among pregnant women at risk for PPD. More specifically, the team will develop a functional prototype of a ROSE Program session, improve the clarity, content, acceptability, and feasibility of the ROSE session using information gathered from a preliminary group of pregnant women and antenatal healthcare providers, and assess the acceptability, feasibility, and usability of the ROSE Program prototype for pregnant women at risk for PPD through pilot testing with our target population. Thus, phase I development will be accomplished by an iterative process of feedback and refinement through collaboration with Debra Fox, President and CEO of Fox Learning Systems, Inc., Dr. Zlotnick at Women and Infants Hospital (WIH), and Dr. Sarah Noble at Paley OB/GYN Clinic of the Albert Einstein Healthcare Network. Fox Learning Systems brings expertise in the development of multimedia health education tools across a range of technology platforms. Dr. Zlotnick at WIH developed the ROSE Program and tested the in-person version of ROSE in randomized control trials with pregnant women on public assistance at risk for PPD, with rural African-American pregnant women, and with pregnant teens. Dr. Noble will provide supervisory and clinical support at the research site in Philadelphia. Phase 1 will lay the foundation for the Phase II development and testing of a Web-based version of ROSE Program that will provide individualized and interactive feedback, retain the core features of the ROSE Program, and represent a low threshold, low-cost service with a high reach. This Web-based intervention to reduce the risk of PPD that is grounded in an empirically supported intervention would improve on products currently available in the marketplace. It will be accessible on kiosks in OB offices, on home devices, and smart phones. Finally, it will be integrated into the prenatal clinic visits of Federally Qualified Health Centers or other inner-city obstetric programs caring for women at high risk for PPD.